Had a very interesting conversation this week which brought home the reality of what can happen when a pediatrician strongly encourages moms to breastfeed, the way that many on this list want them to do.  This young ped is also an IBCLC, BTW, and came into a local group practice hoping to keep more women breastfeeding and also to open a bf clinic-type operation in addition to his regular practice.  Well, long story short, several women left the practice altogether because of the pressure that they felt to breastfeed from this doctor.  Since he is the only one taking new patients, the whole practice lost patients and income because of this.  Needless to say, there was a little sit-down and he has scaled back his plans - not abandoned, but recognizes he must move more slowly or ........  He is a really nice guy and I can't imagine that he strong-armed anyone, but obviously the message got across.  Now if you have the money, or have been around long enough to have the clout, you could run a practice this way and if you lose some moms, so what.  But most docs today are in group practices and young ones certainly don't have any clout.

Personally, I don't think that Tony was a troll.  I think that the issues that he brought up are things that we must deal with on a daily basis and honestly, I don't find it so easy or so black and white either.  We can quote all the statistics we like, but most people look at their immediate group of friends and families to make decisions about many issues.  Most people have friends/family that have obviously suffered from the effects of too much smoking, drinking, eating, etc. and it makes sense to them to be careful about these things.  But if everyone in that group has formula-fed their babies and all of those babies were quite healthy and happy and smart (or the bf weren't any different or even had more illness) then telling that person that formula is poison or giving it is tantamount to child abuse makes absolutely no sense to them at all.  Not only that, but it offends them because you are accusing people that they love and respect of doing something really terrible.  That person is certainly not going to be convinced of the harm of AF, and that person is also then likely to go out and tell a lot of other people about the crazy lactation consultant that accused their sister/mother/best friend of child abuse because they used formula.  And it will all get blown out of proportion, but the damage will be done. This is where we lose a lot of people.

Personally, I don't think that scare tactics make a lot of sense.  I remember in the 60's when adults were telling us that if we took drugs we would all end up in mental wards thinking that we were oranges or something crazy like that.  Well, we all looked around and saw a lot of people who were smoking dope and even dropping acid that seemed perfectly OK ( except for being stoned of course) and decided that adult were idiots and we weren't going to listen to much of anything that they had to say about drugs.  Of course, after years of experience we learned that it wasn't so harmless and some of our friends were not in such good shape.  But if you turn off the listening after the first sentence, then everything else is lost.

I do think that HCPs need to be more supportive and also forthcoming about the dangers of formula supplementation.  But it is a slow process.  If the AAP wants to put their money where their mouth is, they should go after Enfamil in a really big way and get this new promotion of theirs shut down ASAP - I also heard about it from a mom and it is appalling.

The thing is, I think that most people do realize that there are problems with using formula and are open to education in that area.  We need to keep chipping away at the myth of the total safety of AF.  But let's be smart about it.  It is easy to preach to the choir.  Playing a tough room is a whole different story and may require a lot of different tactics.  Let's keep the dialogue going and be inclusive with our thinking.  I think that there are probably a lot of lurkers out there grappling with issues that they are afraid to post about because of the response they know that they will get.  While I appreciate the vast amount of practical knowledge that I have attained through this forum, I do think that we can spend some time looking at some of these other issues without getting too emotional - so much of breastfeeding success is in the mind and we still don't quite know what to do about that.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

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